Lake County Tribal Health Consortium Inc. - Medicare Primary Care in Lakeport, CA

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Lake County Tribal Health Consortium Inc. is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Lakeport, California. The current practice location for Lake County Tribal Health Consortium Inc. is 925 Bevins Ct, Lakeport, California. For appointments, you can reach them via phone at (707) 263-8382. The mailing address for Lake County Tribal Health Consortium Inc. is 925 Bevins Ct, Lakeport, California and phone number is (707) 263-8382.

Lake County Tribal Health Consortium Inc. is licensed to practice in California (license number 110000289). The clinic also participates in the medicare program and its NPI number is 1881697381. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (707) 263-8382.

Contact Information

Lake County Tribal Health Consortium Inc.
925 Bevins Ct
Lakeport
CA 95453-9754
(707) 263-8382
(707) 263-0329

Map and Direction


Primary Care Clinic Profile

Full NameLake County Tribal Health Consortium Inc.
SpecialityClinic/Center
Location925 Bevins Ct, Lakeport, California
Authorized Official Name and PositionErnesto Padilla (EXECUTIVE DIRECTOR)
Authorized Official Contact7072638382
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lake County Tribal Health Consortium Inc.
925 Bevins Ct
Lakeport
CA 95453-9754

Ph: (707) 263-8382		Lake County Tribal Health Consortium Inc.
925 Bevins Ct
Lakeport
CA 95453-9754

Ph: (707) 263-8382

NPI Details:

NPI Number1881697381
Provider Enumeration Date05/27/2005
Last Update Date11/16/2011

Medicare PECOS Information:

Medicare PECOS PAC ID8729975545
Medicare Enrollment IDO20040304000323

Medical Identifiers

Medical identifiers for Lake County Tribal Health Consortium Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1881697381NPI-NPPES
THP70611FMedicaidCA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) 110000289 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Lake County Tribal Health Consortium Inc. acts as a billing entity for following providers:
Provider NameTerri L Turner
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1366522831
PECOS PAC ID: 9830188671
Enrollment ID: I20040507000904
Provider NameFrancisco Tejeda
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1407940075
PECOS PAC ID: 1759343080
Enrollment ID: I20041029000420
Provider NameAndre P Lallande
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1053471045
PECOS PAC ID: 4385680545
Enrollment ID: I20050628001395
Provider NameJavier Arroyo
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1821183732
PECOS PAC ID: 0941226252
Enrollment ID: I20051017000425
Provider NameRonald J Botelho
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1235199373
PECOS PAC ID: 4981702263
Enrollment ID: I20090129000268
Provider NameJoan Devito
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1962549469
PECOS PAC ID: 5597803973
Enrollment ID: I20091104000406
Provider NameEric E Kim
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1578660916
PECOS PAC ID: 4486793551
Enrollment ID: I20091202000616
Provider NameDiane E Bajada
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932354321
PECOS PAC ID: 7810032141
Enrollment ID: I20100310000947
Provider NameMarlene Q Quilala
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1346308855
PECOS PAC ID: 6103951421
Enrollment ID: I20100311000811
Provider NameDaniel G Lewis
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1457390155
PECOS PAC ID: 3072553676
Enrollment ID: I20100324000664
Provider NameLorena A Watson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942558721
PECOS PAC ID: 0042460230
Enrollment ID: I20121024000623
Provider NameSusan R Gamble
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1790950079
PECOS PAC ID: 3779752332
Enrollment ID: I20130115000262
Provider NameHarry D Goldwasser
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1255370680
PECOS PAC ID: 7315901733
Enrollment ID: I20150716001424
Provider NameDerrick J Barnes
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1336236488
PECOS PAC ID: 5294802872
Enrollment ID: I20150717002250
Provider NameAngelo J Chavez Guerrero
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1235465774
PECOS PAC ID: 9537296132
Enrollment ID: I20160225001197
Provider NameSliman Costa Tannous
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1114466521
PECOS PAC ID: 6901183078
Enrollment ID: I20170428000472
Provider NameChalice Ann Addis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306359146
PECOS PAC ID: 8527325695
Enrollment ID: I20171127003137
Provider NameLouise Loe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669924171
PECOS PAC ID: 2163780305
Enrollment ID: I20171218001953
Provider NameRebecca K Cross
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1780048132
PECOS PAC ID: 4082975602
Enrollment ID: I20180222001956
Provider NameAngelo J Alfano
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023503307
PECOS PAC ID: 9931446994
Enrollment ID: I20190129001922
Provider NameGemalli Austin
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1407283419
PECOS PAC ID: 0648513440
Enrollment ID: I20190518000101
Provider NameGladys Muir
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1710054168
PECOS PAC ID: 7618205451
Enrollment ID: I20190819000805
Provider NameCharissa M Barsos
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215309398
PECOS PAC ID: 4880996875
Enrollment ID: I20191008000526
Provider NameShaye Larie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013478569
PECOS PAC ID: 6608102009
Enrollment ID: I20200504000804
Provider NameDawn Marie Pavli
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1649896549
PECOS PAC ID: 9830512680
Enrollment ID: I20200713000561
Provider NameSiamak Sahand
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1609479567
PECOS PAC ID: 2163835927
Enrollment ID: I20210115001510
Provider NameAnna Chacon
Provider TypePractitioner - Dermatology
Provider IdentifiersNPI Number: 1073950689
PECOS PAC ID: 8527207919
Enrollment ID: I20210611002404
Provider NameStephenie L Hargrove
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053927608
PECOS PAC ID: 6305244369
Enrollment ID: I20211006001829
Provider NameKenneth Ian Robbins
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1588778583
PECOS PAC ID: 1759291511
Enrollment ID: I20211018002698
Provider NameDavid Golergant
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1528723459
PECOS PAC ID: 2365834876
Enrollment ID: I20220113000220
Provider NameAmy Lopez
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1467129767
PECOS PAC ID: 8628462280
Enrollment ID: I20220223002993
Provider NameMelissa Flores
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1376925271
PECOS PAC ID: 1254707607
Enrollment ID: I20221026001816
Provider NameYolanda Sorto Castanon
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1205069069
PECOS PAC ID: 0446797732
Enrollment ID: I20240805001520
Provider NameCalai S Brown
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1275117079
PECOS PAC ID: 5698212900
Enrollment ID: I20240805002174
Provider NameDeborah Suzanne Johnson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1649333444
PECOS PAC ID: 9638617533
Enrollment ID: I20240809001643
Provider NameJennifer Sue Nauert
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1437652385
PECOS PAC ID: 7012455967
Enrollment ID: I20240809003956
Provider NameGema R Prieto
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1649564659
PECOS PAC ID: 1456899236
Enrollment ID: I20240812001318
Provider NameTheb Manivanh
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1649459835
PECOS PAC ID: 9537607262
Enrollment ID: I20240813003078
Provider NameStacey Cranfill
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1841747136
PECOS PAC ID: 5698213049
Enrollment ID: I20240815003206
Provider NameHeather Anne Weller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508624297
PECOS PAC ID: 3072053149
Enrollment ID: I20240904004222
Provider NameBrooke H Brody
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1245613819
PECOS PAC ID: 4486194404
Enrollment ID: I20240905001103
Provider NameJulie N Pennington
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1730415019
PECOS PAC ID: 3870034093
Enrollment ID: I20240916001162
Provider NameSuzanne Moineau
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1417194960
PECOS PAC ID: 7113468364
Enrollment ID: I20240916002212
Provider NameAlireza R Sadre-nassiri
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1740544303
PECOS PAC ID: 4981145596
Enrollment ID: I20240924000396
Provider NameMarlin Noelia Duran
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1144839853
PECOS PAC ID: 1850822859
Enrollment ID: I20241001004012
Provider NameFlorencia Karina Miranda Chumpitaz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356121404
PECOS PAC ID: 0345771291
Enrollment ID: I20241002001287
Provider NameAngela Marie Knight
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1801939053
PECOS PAC ID: 0749711653
Enrollment ID: I20241002003767
Provider NameLiliana Caicedo
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1508140591
PECOS PAC ID: 5092246769
Enrollment ID: I20241004002315
Provider NameEmily Tang
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497141832
PECOS PAC ID: 4385175074
Enrollment ID: I20241004003155
Provider NameJai Lee
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1164497319
PECOS PAC ID: 2163567611
Enrollment ID: I20241008002029
Provider NameSteve P Murphy
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1346435872
PECOS PAC ID: 9133367220
Enrollment ID: I20241009000614
Provider NameSunny H Park
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1568878478
PECOS PAC ID: 4486975059
Enrollment ID: I20241021003054
Provider NameGholamreza Rezvani
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1437813029
PECOS PAC ID: 5890229140
Enrollment ID: I20241111000178
Provider NameEliezer N Melendez
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1518926393
PECOS PAC ID: 5698735496
Enrollment ID: I20241114004359
Provider NameLynnis L Mairena
Provider TypePractitioner - Marriage And Family Therapist
Provider IdentifiersNPI Number: 1558872846
PECOS PAC ID: 8729512256
Enrollment ID: I20241120004190

Reviews and Comments


Clinic/Center in Lakeport, CA


Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 5176 Hill Rd E, Lakeport, CA 95453
Phone: 707-262-5001    Fax: 707-262-5006

Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 5176 Hill Rd E, Lakeport, CA 95453
Phone: 707-262-5000    Fax: 707-262-5005
Northern California Medical Assoc Inc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 55 1st St, Ste 210, Lakeport, CA 95453
Phone: 707-462-1516    Fax: 707-462-1178
Adventist Health Physicians Network
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 801 11th St, Lakeport, CA 95453
Phone: 707-263-3746    

Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 359 Lakeport Blvd, Lakeport, CA 95453
Phone: 707-533-2700    Fax: 707-263-5400
Northern California Medical Assoc Inc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 5108 Hill Rd E, Lakeport, CA 95453
Phone: 707-262-1840    Fax: 707-262-5844

Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 5196 Hill Rd E, Suite 300, Lakeport, CA 95453
Phone: 707-263-6885    Fax: 707-263-6624

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.